Organization
KNOWLEDGE OF SELF THERAPEUTIC SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARKISHA BENNETT PSY.D. (LICENSED CLINICAL PSYCHOLOGIST)
(954) 681-0669
Entity
Organization
Contact information
Practice address
1629 K ST NW, SUITE 300, WASHINGTON, DC 20006-1602
(202) 885-5798
Mailing address
1105 IVY CLUB LN, UNIT 342, LANDOVER, MD 20785-4513
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY1000740
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1356611586
NPI
MD
Enumeration date
05/13/2015
Last updated
05/13/2015
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